Endovascular Procedures For Lower Extremity Vascular Disease

2013 ◽  
Author(s):  
Mark G. Davies
Keyword(s):  
Lower Extremity ◽  
Vascular Surgery ◽  
Vascular Disease ◽  
Endovascular Procedures ◽  
Vascular Diseases ◽  
Patient Treatment ◽  
Surgical Approaches ◽  
Endovascular Techniques ◽  
First Line ◽  
Treatment Algorithms

The application of endovascular procedures to lower extremity vascular disease is now established as the first-line intervention and has supplanted conventional open surgical approaches for most common vascular diseases. This new review details several common endovascular techniques and therapies used in the lower extremity arterial and venous systems by vascular surgery providers. The author's comprehensive approach to each procedure includes preprocedure “basics,” technical steps, adjunct therapies, troubleshooting, and postprocedure outcomes and considerations. There are three treatment algorithms, six figures, and 78 references in this chapter. As endovascular therapy for patients with lower extremity disease evolves, the algorithms for patient treatment are likely to evolve in concert.

Endovascular Procedures For Lower Extremity Vascular Disease: Basics of Endovascular Intervention

2018 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Mark Davies
Keyword(s):  
Lower Extremity ◽  
Vascular Disease ◽  
Endovascular Procedures ◽  
Vascular Diseases ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Surgical Approaches ◽  
Acute Ischemia ◽  
Acute Limb Ischemia ◽  
Access Complications

The application of endovascular procedures to lower-extremity vascular disease is well established for many common vascular diseases and has often supplanted conventional open surgical approaches. Endovascular therapy for arterial disease in the lower extremity encompasses treatment of acute ischemia, chronic ischemia, and aneurysmal disease. The fundamental skill set and techniques employed are common to all these processes. This chapter details these techniques and therapies. Key words: access closure, access complications, acute limb ischemia, chronic limb ischemia, intravascular ultrasonography, lower-extremity angiogram, transcollateral access, transpopliteal access

Endovascular Procedures For Lower Extremity Vascular Disease: Basics of Endovascular Intervention

2018 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Mark Davies
Keyword(s):  
Lower Extremity ◽  
Vascular Disease ◽  
Endovascular Procedures ◽  
Vascular Diseases ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Surgical Approaches ◽  
Acute Ischemia ◽  
Acute Limb Ischemia ◽  
Access Complications

The application of endovascular procedures to lower-extremity vascular disease is well established for many common vascular diseases and has often supplanted conventional open surgical approaches. Endovascular therapy for arterial disease in the lower extremity encompasses treatment of acute ischemia, chronic ischemia, and aneurysmal disease. The fundamental skill set and techniques employed are common to all these processes. This chapter details these techniques and therapies. Key words: access closure, access complications, acute limb ischemia, chronic limb ischemia, intravascular ultrasonography, lower-extremity angiogram, transcollateral access, transpopliteal access

Endovascular Procedures For Lower Extremity Vascular Disease: Specifics of Endovascular Treatment

2018 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Mark Davies
Keyword(s):  
Lower Extremity ◽  
Endovascular Treatment ◽  
Vascular Disease ◽  
Endovascular Procedures ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Surgical Approaches ◽  
Acute Ischemia ◽  
Acute Limb Ischemia ◽  
Chronic Ischemia

The application of endovascular procedures to lower-extremity vascular disease is well established for many common vascular diseases and has often supplanted conventional open surgical approaches. Endovascular therapy for arterial disease in the lower extremity encompasses treatment of acute ischemia, chronic ischemia, and aneurysmal disease. The fundamental skill set and techniques employed are common to all these processes. This chapter details the management of chronic ischemia, acute lower-extremity arterial ischemia, pseudoaneurysms and aneurysms, and arteriovenous malformations. Key words: access closure, access complications, acute limb ischemia, aneurysm endovascular treatment, chronic limb ischemia, intravascular ultrasonography, lower-extremity angiogram, lower limb ischemia, percutaneous transluminal angioplasty, transcollateral access, transpopliteal access

Endovascular Procedures For Lower Extremity Vascular Disease: Specifics of Endovascular Treatment

2018 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Mark Davies
Keyword(s):  
Lower Extremity ◽  
Endovascular Treatment ◽  
Vascular Disease ◽  
Endovascular Procedures ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Surgical Approaches ◽  
Acute Ischemia ◽  
Acute Limb Ischemia ◽  
Chronic Ischemia

The application of endovascular procedures to lower-extremity vascular disease is well established for many common vascular diseases and has often supplanted conventional open surgical approaches. Endovascular therapy for arterial disease in the lower extremity encompasses treatment of acute ischemia, chronic ischemia, and aneurysmal disease. The fundamental skill set and techniques employed are common to all these processes. This chapter details the management of chronic ischemia, acute lower-extremity arterial ischemia, pseudoaneurysms and aneurysms, and arteriovenous malformations. Key words: access closure, access complications, acute limb ischemia, aneurysm endovascular treatment, chronic limb ischemia, intravascular ultrasonography, lower-extremity angiogram, lower limb ischemia, percutaneous transluminal angioplasty, transcollateral access, transpopliteal access

Classification Systems for Lower Extremity Occlusive Disease

2015 ◽  
Author(s):  
David L. Cull
Keyword(s):  
Risk Stratification ◽  
Lower Extremity ◽  
Vascular Surgery ◽  
Vascular Disease ◽  
Mortality Risk ◽  
Classification System ◽  
Limb Ischemia ◽  
Classification Systems ◽  
Occlusive Disease ◽  
Chronic Limb Ischemia

The management of lower extremity occlusive disease involves some of the most complex decision making in the field of vascular surgery. Patients with lower extremity occlusive disease often present with a wide spectrum of clinical manifestations ranging from mild intermittent claudication to severe ischemia with gangrene. Moreover, the prognosis and clinical management are dependent on the location and extent of the atherosclerotic disease burden, the presence of comorbid conditions that affect life expectancy and procedural patency, the revascularization options available, and the functional status of the patient. In an effort to bring order to this challenging disease, a number of lower extremity classification systems have been developed. This review discusses challenges of establishing a classification system, anatomic classification systems, classification systems based on presenting symptoms/clinical presentation, morbidity/mortality risk stratification systems, and disability classification systems. Tables outline the Society for Vascular Surgery runoff score, clinical categories of acute limb ischemia, Rutherford clinical categories of chronic limb ischemia, Fontaine clinical stages of chronic limb ischemia, LEGS (Lower Extremity Grading System) score used to recommend invasive treatment for patients with chronic lower extremity ischemia, WIfI (Wound Ischemia foot Infection) classification system grades, consensus estimate of 1 year amputation risk and likelihood of benefit of/requirement for revascularization based on WIfI spectrum score, predicted and observed 1-year outcomes (limb amputation, wound nonhealing) based on WIfI clinical stage classification, morbidity and mortality risk stratification methods, US social security administration disability criteria for patients with lower extremity occlusive disease and amputation, and criteria for rating impairment due to lower extremity peripheral vascular disease. Figures illustrate the TransAtlantic Inter-Society Consensus classification of aortoiliac and femoropopliteal lesions and Graziani System classes of progressive vascular disease severity and distribution in patients with diabetes mellitus presenting with foot wounds. This review contains 3 figures, 11 tables, and 35 references.

Endothelial Dysfunction and Inflammatory Markers of Vascular Disease

2020 ◽  
Vol 19 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Sevket Balta
Keyword(s):  
Endothelial Dysfunction ◽  
Vascular Disease ◽  
Inflammatory Markers ◽  
Vascular Diseases ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Non Invasive ◽  
Von Willebrand ◽  
The Relationship ◽  
Willebrand Factor

: Vascular diseases are the main reason for morbidity and mortality worldwide. As we know, the earlier phase of vascular diseases is endothelial dysfunction in humans, the endothelial tissues play an important role in inflammation, coagulation, and angiogenesis, via organizing ligand-receptor associations and the various mediators’ secretion. We can use many inflammatory non-invasive tests (flowmediated dilatation, epicedial fat thickness, carotid-intima media thickness, arterial stiffness and anklebrachial index) for assessing the endothelial function. In addition, many biomarkers (ischemia modified albumin, pentraxin-3, E-selectin, angiopoietin, endothelial cell specific molecule 1, asymmetrical dimethylarginine, von Willebrand factor, endothelial microparticles and endothelial progenitor cells) can be used to evaluate endothelial dysfunction. We have focused on the relationship between endothelial dysfunction and inflammatory markers of vascular disease in this review.

scholarly journals Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yitzhak Brzezinski-Sinai ◽  
Ester Zwang ◽  
Elena Plotnikova ◽  
Ester Halizov ◽  
Itzhak Shapira ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
General Anesthesia ◽  
Vascular Disease ◽  
Cholinesterase Activity ◽  
Serum Cholinesterase ◽  
Hemodynamic Support ◽  
System A ◽  
Lower Baseline ◽  
Increased Risk ◽  
A Prospective Study

AbstractMaintaining hemodynamic stability during the induction and maintenance of anesthesia is one of the challenges of the anesthesiologist. Patients with vascular disease are at increased risk of instability due to imbalance between the sympathetic and parasympathetic parts of the autonomic nervous system, a balance accessible by serum cholinesterase activity. We aim to characterize the dynamics of cholinesterase activity in patients undergoing general anesthesia (GA) and surgery. This was a prospective study of 57 patients undergoing ambulatory or vascular surgery under GA. Cholinesterase activity was measured before the induction of anesthesia, after 15 min and at the end of surgery by calculating the capacity of serum acetylcholinesterase (AChE) and butyrylcholinesterase to hydrolyze AcetylThioCholine. Data on atherosclerotic disease, anesthesia management were analyzed. Both AChE and total cholinergic status (CS) decreased significantly after GA induction at 15 min and even more so by the end of surgery. Vascular surgery patients had lower baseline cholinesterase activity compared to ambulatory surgery patients. Patients requiring intraoperative administration of phenylephrine for hemodynamic support (21.1%) had a significantly lower level of AChE and CS compared to untreated patients. Our findings serve as a mirror to the sympathetic/parasympathetic imbalance during GA, with a marked decrease in the parasympathetic tone. The data of a subgroup analysis show a correlation between low cholinesterase activity and an increase in the need for hemodynamic support.

Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures

2021 ◽  
pp. 197140092110291
Author(s):  
Thomas Mellemkjær ◽  
Ronil V Chandra ◽  
Lasse Speiser ◽  
Benedicte P Ulhøi ◽  
Claus Z Simonsen
Keyword(s):  
Polymer Material ◽  
Endovascular Procedures ◽  
Rare Complication ◽  
Diagnostic Process ◽  
Line Treatment ◽  
Review Of The Literature ◽  
First Line ◽  
Stroke Treatment ◽  
Oral Glucocorticoids ◽  
First Line Treatment

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. We present our diagnostic process, including biopsy results in two patients, our anti-inflammatory treatment and outcomes together with a review of the literature. In our series, prognosis was variable with ongoing seizures in two patients. Our literature review reveals that asymptomatic shedding of polymer material is common, occurring in a third of endovascular stroke procedures, whereas symptomatic DL occurs in <0.5% of therapeutic neuroendovascular procedures. Clinicians should be aware of this rare complication, and oral glucocorticoids seem to be a reasonable first-line treatment strategy.

Arterial Thrombosis and Gangrene Secondary to Arachnidism

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 239-242
Author(s):  
Jan M. Eckermann ◽  
Theodore H. Teruya ◽  
Christian Bianchi ◽  
Ahmed M. Abou-Zamzam
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Vascular Disease ◽  
Tissue Damage ◽  
Arterial Thrombosis ◽  
Progressive Necrosis ◽  
Life Threatening ◽  
History Of ◽  
Spider Bites ◽  
Spider Bite

Spider bites can cause local tissue damage as well as life-threatening complications. This is a case report of a female with no history of lower extremity vascular disease who presented with a spider bite on the dorsum of her foot. She developed progressive necrosis and eventually suffered limb loss despite attempts at revascularization.

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